Elevations of serum cancer biomarkers correlate with severity of COVID‐19

Wei, Xin; Su, Jingyu; Yang, Kunyu; Wei, Jiazhou; Wan, Huihui; Cao, Xiaoling; Tan, Wenbin; Wang, Hui

doi:10.1002/jmv.25957

Cited by 63 publications

(110 citation statements)

References 21 publications

(51 reference statements)

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“…However, the role of CEA levels in clinical outcomes or CT involvements of COVID-19 patients was still unknown. This study validated the previous result that CEA levels were related to severity of COVID-19 reported by different research groups (Union Hospital of Tongji Medical College, Wuhan) ( 19 ). Furthermore, our study concentrated on different CEA levels in COVID-19 patients with different clinical outcomes (survivors or non-survivors) and potential correlations with CT involvement scores.…”

Section: Discussionsupporting

confidence: 91%

“…Moreover, increasing levels of serum CEA were associated with more CT involvement scores in discharged COVID-19 patients. Till now, only one study reported the elevated serum CEA levels in COVID-19 patients ( 19 ). In that retrospective study, the authors found significant increases of CEA levels compared with health controls and a potential association between CEA and CRP levels.…”

Section: Discussionmentioning

confidence: 99%

“…Similar to pathological changes of ILD, significant hyperplasia of type II alveolar epithelial cells and interstitial fibrosis were referred to from several reports of COVID-19 autopsies and biopsies ( 17 , 18 ). To our knowledge, only one study about the serum cancer biomarkers including CEA levels of COVID-19 patients have been published ( 19 ). Whether elevated CEA levels are associated with poor prognosis or severity of COVID-19 remains unclear nevertheless.…”

Section: Introductionmentioning

confidence: 99%

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Carcinoembryonic Antigen: A Potential Biomarker to Evaluate the Severity and Prognosis of COVID-19

Chen

Kong

et al. 2020

Front. Med.

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Background and Objectives: Corona Virus Disease 2019 (COVID-19) has become a serious pandemic disease worldwide. Identification of biomarkers to predict severity and prognosis is urgently needed for early medical intervention due to high mortality of critical cases with COVID-19. This retrospective study aimed to indicate the values of carcinoembryonic antigen (CEA) in evaluating the severity and prognosis of COVID-19. Methods: We included 46 death cases from intensive care unit and 68 discharged cases from ordinary units with confirmed COVID-19 of Wuhan Jin Yin-tan Hospital from January 1 to March 22, 2020. Laboratory and radiologic data were analyzed retrospectively. All patients were followed up until April 10, 2020. Results: COVID-19 patients in the death group had significantly higher CEA levels (ng/ml) than discharged group (14.80 ± 14.20 vs. 3.80 ± 2.43, P < 0.001). The risk of COVID-19 death increased 1.317 times for each additional 1 ng/ml CEA level (OR = 1.317, 95% CI: 1.099–1.579). The standardized and weighted receiver operating characteristic curve (ROC) analysis adjusted to age, sex, and ferritin levels suggested that the area under the curve (AUC) of the serum CEA levels was 0.808 in discrimination between death cases and discharged cases with COVID-19 ( P < 0.001). We found mortality of COVID-19 is associated with elevated CEA levels increased (HR = 1.023, 95% CI: 1.005–1.042), as well as age (HR = 1.050, 95% CI: 1.016–1.086) and ferritin levels (HR = 1.001, 95% CI: 1.001–1.002) by survival analysis of Cox regression model. Among discharged patients, CEA levels were significant lower in moderate cases compared to the severe and critical cases ( P = 0.005; OR = 0.488, 95% CI: 0.294–0.808) from binary logistic regression analysis. The AUC of CEA levels was 0.79 in distinguishing moderate cases from discharged COVID-19 patients by standardized and weighted ROC analysis ( P < 0.001). A positive correlation between CEA levels and CT scores existed in discharged patients (Correlation Coefficient: 0.687; P < 0.001). Conclusions: Elevated CEA levels increased the risk of death from COVID-19 and CEA levels were related to CT scores of the discharged patients positively.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Carcinoembryonic Antigen: A Potential Biomarker to Evaluate the Severity and Prognosis of COVID-19

Chen

Kong

et al. 2020

Front. Med.

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“…Xiuqu W. et al showed elevations of serum cancer biomarkers in COVID-19 patients: squamous cell carcinoma antigens (SCC) and CA19.9 only in critical cases, carcinoembryonic antigen (CEA), carbohydrate antigens (CA-125, CA-153), cytocheretin-19 fragment (CYFRA21-1), HE4 in mild, severe and critical cases and concluded that elevations of these biomarkers is correlated with the pathological progressions of COVID-19 [40].…”

Section: Introductionmentioning

confidence: 99%

New Insights in Laboratory Testing for COVID-19 Patients: Looking for the Role and Predictive Value of Human epididymis secretory protein 4 (HE4) and the Innate Immunity of the Oral Cavity and Respiratory Tract

et al. 2020

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COVID-19 is a viral pandemic caused by the new coronavirus SARS-CoV-2, an enveloped positive stranded RNA virus. The mechanisms of innate immunity, considered as the first line of antiviral defense, is essential towards viruses. A significant role in host defense of the lung, nasal and oral cavities is played by Human epididymis secretory protein 4 (HE4) HE4 has been demonstrated to be serum inflammatory biomarker and to show a role in natural immunity at the level of oral cavity, nasopharynx and respiratory tract with both antimicrobial/antiviral and anti-inflammatory activity. Several biomarkers like IL-6, presepsin (PSP), procalcitonin (PCT), CRP, D-Dimer have showed a good function as predictor factors for the clinical evolution of COVID-19 patients (mild, severe and critical). The aim of this study was to correlate the blood levels of CRP, IL-6, PSP, PCT, D-Dimer with He4, to identify the predictive values of these biomarkers for the evolution of the disease and to evaluate the possible role of HE4 in the defense mechanisms of innate immunity at the level of oral cavity, nasopharynx and respiratory tract. Of 134 patients admitted at COVID hospital of Policlinico—University of Bari, 86 (58 men age 67.6 ± 12.4 and 28 women age 65.7 ± 15.4) fulfilled the inclusion criteria: in particular, 80 patients (93%) showed prodromal symptoms (smell and/or taste dysfunctions) and other typical clinical manifestations and 19 died (13 men age 73.4 ± 7.7 and 6 women age 74.8 ± 6.7). 48 patients were excluded because 13 finished chemotherapy and 6 radiotherapy recently, 5 presented suspected breast carcinoma, 5 suspected lung carcinoma, 6 suspected ovarian carcinoma or ovary cyst, 1 cystic fibrosis, 3 renal fibrosis and 9 were affected by autoimmune diseases in treatment with monoclonal antibodies. The venous sample was taken for each patient on the admission and during the hospital stay. For each patient, six measurements relating to considered parameters were performed. Significant correlations between He4 and IL-6 levels (r = 0.797), between He4 and PSP (r = 0.621), between He4 and PCT (r = 0.447), between He4 and D-Dimer (r = 0.367), between He4 and RCP (r = 0.327) have been found. ROC curves analysis showed an excellent accuracy for He4 (AUC = 0.92) and IL-6 (AUC = 0.91), a very good accuracy for PSP (AUC = 0.81), a good accuracy for PCT (AUC = 0.701) and D-Dimer (AUC = 0.721) and sufficient accuracy for RCP (AUC = 0.616). These results demonstrated the important correlation between He4, IL6 and PSP, an excellent accuracy of He4 and IL6 and showed a probable role of He4 in the innate immunity in particularly at the level of oral cavity, nasopharynx and respiratory tract. Besides He4 together with IL6 might be involved in the onset of smell and/or taste disorders and it might be used as innovative biomarker to monitor clinical evolution of COVID-19 because He4 could indicate a multi-organ involvement.

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“…Besides the elevation of several inflammatory/immunological biomarkers, they also noticed a positive association between the levels of cancer biomarkers with disease severity. 132 In a study, the proteomic and metabolic profiling of patient plasma, including samples from patients before they progressed to severe disease, was carried out using TMT. 133 To predict if a patient will develop severe disease, the data were fed into a machine learning model that was then trained.…”

Section: Coronavirusesmentioning

confidence: 99%

Utility of Proteomics in Emerging and Re-Emerging Infectious Diseases Caused by RNA Viruses

et al. 2020

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Emerging and re-emerging infectious diseases due to RNA viruses cause major negative consequences for the quality of life, public health, and overall economic development. Most of the RNA viruses causing illnesses in humans are of zoonotic origin. Zoonotic viruses can directly be transferred from animals to humans through adaptation, followed by human-to-human transmission, such as in human immunodeficiency virus (HIV), severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), and, more recently, SARS coronavirus 2 (SARS-CoV-2), or they can be transferred through insects or vectors, as in the case of Crimean-Congo hemorrhagic fever virus (CCHFV), Zika virus (ZIKV), and dengue virus (DENV). At the present, there are no vaccines or antiviral compounds against most of these viruses. Because proteins possess a vast array of functions in all known biological systems, proteomics-based strategies can provide important insights into the investigation of disease pathogenesis and the identification of promising antiviral drug targets during an epidemic or pandemic. Mass spectrometry technology has provided the capacity required for the precise identification and the sensitive and high-throughput analysis of proteins on a large scale and has contributed greatly to unravelling key protein–protein interactions, discovering signaling networks, and understanding disease mechanisms. In this Review, we present an account of quantitative proteomics and its application in some prominent recent examples of emerging and re-emerging RNA virus diseases like HIV-1, CCHFV, ZIKV, and DENV, with more detail with respect to coronaviruses (MERS-CoV and SARS-CoV) as well as the recent SARS-CoV-2 pandemic.

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Elevations of serum cancer biomarkers correlate with severity of COVID‐19

Abstract: In this retrospective study, we evaluated the levels of a series of serum biomarkers in coronavirus disease 2019 (COVID-19) patients (mild: 131; severe: 98; critical: 23). We found that there were significant increases in levels of human epididymis protein 4 (HE4)

Cited by 63 publications

References 21 publications

Carcinoembryonic Antigen: A Potential Biomarker to Evaluate the Severity and Prognosis of COVID-19

Carcinoembryonic Antigen: A Potential Biomarker to Evaluate the Severity and Prognosis of COVID-19

New Insights in Laboratory Testing for COVID-19 Patients: Looking for the Role and Predictive Value of Human epididymis secretory protein 4 (HE4) and the Innate Immunity of the Oral Cavity and Respiratory Tract

Utility of Proteomics in Emerging and Re-Emerging Infectious Diseases Caused by RNA Viruses

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